Provider Demographics
NPI:1427860659
Name:LEMBOYE, OLUFUNKE VERONICA
Entity type:Individual
Prefix:
First Name:OLUFUNKE
Middle Name:VERONICA
Last Name:LEMBOYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 CITATION DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4530
Mailing Address - Country:US
Mailing Address - Phone:817-689-8384
Mailing Address - Fax:
Practice Address - Street 1:2106 CITATION DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-4530
Practice Address - Country:US
Practice Address - Phone:817-689-8438
Practice Address - Fax:682-351-7514
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1183100363L00000X
TXAG11240101363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner